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Are you looking for a comprehensive coverage health insurance plan that you can customize to suit your needs and budget? If so, one of our Series V Products is right for you. These health insurance plans offer you a comprehensive package of benefits to meet your needs now and in the future.
Our Series V Products include:
Key coverage and health insurance plan features include:
BlueChoice® Network: The BlueChoice® network allows you to save on premiums and the cost of covered services when you use a contracting BlueChoice® hospital, doctor or specialist. You do not need to select a primary care physician or obtain a referral to see a specialist.
A Series V health insurance plan may be right for you if you are an individual or family who:
We offer three Series V Products that provide different levels of out-of-pocket expense limits, deductibles, coinsurance and network coverage to allow you to select the health insurance plan that best meets your budget. Compare the coverage to find the one that's right for you.
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Texas family.
For more information on costs, including out-of-pocket costs, see the Outline of Coverage documents under What's Included with Series V Products — More Health Insurance Plan Details.
* Represents estimated cost range for in-network coverage only. Out-of-network coverage costs can be significantly higher. Your greatest coverage and savings are realized when you use the services of participating providers within the network.
It's important to know the features of the health insurance plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of our Series V Products, as well as details on renewability, exclusions and limitations.
You can customize any Series V health insurance plan with the following option:
Optional Dental Coverage
This chart is a representation of Network benefits. Please refer to the Outline of Coverage for Out-of-Network benefits
|Benefit Highlight||PPO Select®|
|PPO Select® Choice||PPO Select® Saver|
|Participating Providers||BlueChoice® or BlueCard® PPO|
|Individual Out-of-Pocket Expense Limit||Deductible plus $3,000||Deductible plus $3,000||Deductible plus $3,000|
|Preventive Care||100% of Allowable Amount (no Deductible)||100% of Allowable Amount (no Deductible)||100% of Allowable Amount (no Deductible)|
|Office Visit Copay||$25 (Includes Lab Work)||$25||Deductible and Coinsurance|
|Childhood Immunizations||100% of allowable amount to 8 years of age||100% of allowable amount to 8 years of age||100% of allowable amount to 8 years of age|
|Coinsurance||Plan pays 85% of allowable amount and member pays 15% after deductible||Plan pays 80% of allowable amount and member pays 20% after deductible||Plan pays 75% of allowable amount and member pays 25% after deductible|
|Optional Dental Coverage Deductible||$50||$50||$50|
|Prescription Drugs||Copay — $10 generic, $30 preferred, $45 non-preferred||Copay — $10 generic, $30 preferred, $45 non-preferred||Copay — $10 generic, $40 preferred, $55 non-preferred|
|Prescription Drug Deductible||None||$200||$200|
|Prescription Drug Utilization/ Benefit Management Programs||Member Pay the Difference: When choosing a brand name drug over an available generic equivalent, you pay your usual share plus the difference in cost.
For policies with effective dates on or after 3/1/2012:
Dispensing Limits: Benefits include coverage limits on certain quantities of medications.
Specialty Pharmacy Program: To be eligible for maximum benefits, specialty medications must be obtained through the preferred Specialty Pharmacy Provider.
View the Specialty Pharmacy Program List which includes a reminder about coverage for self-administered specialty medications.
Prior Authorization/Step Therapy Requirements: Before receiving coverage.
|Outline of Coverage||Outline of Coverage||Outline of Coverage|
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